Singapore (26 October – 1 November 2014)
Arrival - Day 0 (Sun, 26th October 2014)
We arrived in Singapore on a Sunday. The airport transfer was right on time although we was
not informed about the arrangement. We were brought to the Park Royal hotel where we
stayed the week. This hotel is located in a strategic location in the north region and only a 10
minutes drive from NUH. The neighbouring Rochester Mall sited next to the lush greenery of
Rochester Park, provided an exceptional dining experience. It is also located next to the huge
Star Vista shopping mall and also the Buona Vista Mass Rapid Transit (MRT), which is only 2
stops away from the NUH MRT station. It’s a brand new hotel. We were placed in a twin
sharing room initially, but upgraded to a lovely suite with 2 separate rooms from Tuesday
onwards. It was unfortunate that even upon arrival, the programme for the rest of the week
was not made available to us for reference.
Day 1
(Mon, 27th October)
On our first day, as we were unaware of the programme for the day, we arrived late to the
National University of Singapore Hospital. Due our delayed arrival, our scheduled
presentations were postponed to the following day. However, we were greeted warmly by
Prof HK Wong, A/Prof Gabriel Liu, A/Prof KS Naresh and the rest of the Orthopaedic
department staff. We were given a brief tour around the orthopaedic facilities in NUH. We
were impressed by the University Spine Center and Orthopaedic Clinic which houses a EOS
imaging system which provides 2D and 3D imaging with low dose radiation. This is especially
useful in spinal deformity assessment.
We proceeded to join Prof HK Wong in the operation theatre. He performed a posterior spinal
fusion on a 15-year-old boy with Lenke 5 idiopathic scoliosis. Dr Hsieh was given the
opportunity to scrub in to assist this surgery. The use of the pedigard pedicle finder for
pedicle screw insertion was shown to us. We managed to observe another surgery performed
by A/Prof Gabriel Liu. He did a MIS TLIF surgery combined with navigation technique for the
pedicle screws. The navigation technique was aimed to reduce the radiation during pedicle
screws insertion.
After the surgeries, we were treated to the signature curry crab at the famous ‘No Signboard
Seafood Restaurant’ together with the whole spine unit. After the scrumptious dinner, we
had the opportunity to enjoy the stunning water front scenery next to the restaurant.
Day 2
(Tue, 28th October)
On our second day, Dr Kim YH presented his topic in ‘Research and Updates in Studies of the
Spinal Cord Injuries’. It was followed by Dr Tzeng ST’s presentation, ‘Stage Posterior
Correction in the Treatment of Severe Rigid Scoliosis or Kyphosis’. We joined Prof HK Wong
later in the operation theatre where he performed an anterior scoliosis surgery for a Lenke 5
curve combining the conventional open technique (for lumbar levels) with the thoracoscopic
surgery (for the thoracic levels). Dr. Kim YH scrubbed in. The second surgery was an ACDF for
cervical spinal stenosis performed by Dr Hey. In the operation theatre complex, Prof Wong HK
managed to share his experience, tricks and pearls for his renowned thoracoscopic scoliosis
surgery.
Dinner was a delightful experience where we had the famous traditional Herbal Meat Soup
‘Bakuteh’ hosted by Dr Lau. This delicacy started out as the daily diet of the Chinese
labourers at the harbour during the colonial times. After dinner, Dr Lau brought us to the
Marina Barrage as well as to the Garden by the Bay. Marina Barrage houses the state of the
art water recycling technology and the Garden by the Bay is a huge indoor garden where the
world’s largest columnless greenhouse resides.
Day 3
(Wed, 27th March)
We started day 3 by joining the Singapore General Hospital Spine team’s case presentations
and discussion. A/Prof Tan Seang Beng, A/Prof Yue Wai Mun and Dr John Chen greeted us
warmly. After a short tour of the ward and clinic, we had our breakfast with the spine team
at the O’Briens Irish Sandwich Café. After breakfast, A/Prof Yue Wai Mun led us to the SGH
Museum. Housed in the Bowyer Block, an architectural landmark in the SGH Campus, the SGH
Museum is a repository of artefacts and records, where visitors can trace the long and rich
history of the Singapore General Hospital. For dinner, A/Prof Gabriel Liu treated us to an
authentic Chinese cuisine meal at the Imperial Treasure Restaurant at Marina Bay Sands.
Before entering the restaurant we were able to catch a bird’s eye view of the luxurious
casino beneath.
Day 4 (Thurs, 28th – Sat, 30th March)
We started the day with presentations by Dr Hsieh MK, ‘A study in cases treated with MIS TLIF’
followed by Dr Khoo EH’s presentation, ‘Tuberculosis Of The Spine in An 17 Month Old Toddler:
A Case Report And Review Of Management in Pediatric Pott's Disease’. A/Prof KS Naresh and
Dr GK Lau presented their award wining research and had an interesting case discussion.
After lunch, we joined A/Prof Angelo for a tour of the Singapore Institute of Neurotechnology
(SINAPSE) and the NUS Tissue Engineering Program Laboratory. We were deeply impressed by
the cutting edge technologies presented to us.
The following afternoon we took the opportunity to explore the famous tourist attraction at
Sentosa Island.
Day 5 - 6 (Thurs, 28th – Sat, 30th March)
We joined A/Prof Naresh during surgery where we were introduced to the expandable screws
from Arthrotech. Dinner was at another Bakuteh restaurant. After dinner we took a stroll
down the famous high end shopping street- Orchard Road, which was beautifully decorated
with colourful lights and street decorations.
On Saturday, A/Prof Gabriel brought us to the Garden by the Bay. We were awed by the
beautiful nature presented here, much more spectacular when seen in broad daylight. We
took the 22-seater Garden Cruiser tram and go on a leisurely 25 minutes ride with
informative commentary around Bay South Garden. Then we feasted our eyes in Flower
Dome and Cloud Forest, a twin giant air-conditioned conservatories with features a variety of
flowers and plants around the world. We had our lunch with A/Prof Gabriel at the Supertree
Dining by IndoChine, a pretiguous yet unique restaurants resides on top of the tallest
supertree there. After lunch, we thanked our dearest host for a fruitful week and we bade
farewel.
Bangkok (2nd November – 7th November 2014)
Day 1
On November 1 ,after we arrive at Bangkok airport and then on shuttle bus to
Golden Tulip hotel just near Bangkok general bospital. We have advise the
secretary in Malaysia that could we separate our room but responsed as to be
shared because of budget.
Day2
On November 2,we visit Department of orthopaedic,Chulalongkorn hospital.
Prof. Aree Tanavalee, the APKS president, take us inside operation
theatre .Prof. Wicharn Yingsakmongkol have two operations: one is 60 y/o
male with cervical spondylotic myelopathy ,ACDF with plate C4-7 was
performed with a very fast speed and give us a lecture about his clinical
research.The other operation is L2-3 instability and he performed XLIF L2-3
with plate-screw fixation.
Day3
On November 3
We visit Department of orthopaedic Faculty of medicine Siriraj Hospital
(Mahidol university) and joined the difficult case discussion and one of our
fellow present his data . Prof. Cheron Chotigavanich (APOA president) present
minimally invasive method to treated osteoporotic compression fracture
patients .In the afternoon colleges of Professor Saranatra Waikakul guided us
to Grand Palace for a detail tour to realize the history of Thailand . At night ,
Prof. Cheron Chotigavanich bring us to a nice Thailand food restaurant near
Chaophya river.
Day4
On November 4
We visit the Department of orthopaedic of Rajvithi hospital(public hospital).
Dr. Athikom Methathien give us a lecture of spinal osteotomy and fracture
treatment .He performed a pedicle substraction osteotomy and long
instrumentation fixation on a 30 y/o ankylosing spondylitis male patient .
Day5
On November 5
In the morning ,we visit Department of Samitivej hospital and Professor Prof.
Cheron Chotigavanichl give us a introduction about the hospital and take us to
every part of the department .The Samitivej hospital passed JCI certification
for 4 years and undergoing mock survey when we in hospital.In the afternoon ,
Prof. Cheron Chotigavanich take us to visit Chaophya hospital and with his
colleges blessed for future beside the Chaophya river in Loy kratong festival.
Day6
On November 6
Department of orthopaedic,Ramathibodi hospital
Today we visited Ramathibodi Hospital, one of the teaching hospitals of
Mahidol University. At there we met Dr. Gun Keorochana, he is Dr Tzeng’s old
friend during their fellowship in the UCLA. We take a guide tour around the
hospital. After that, we visited the operation theatre to see two surgeries. One
is ACDF for multi-level cervical spondylotic myelopathy, the second one is
posterior decompression and instrumented fusion using RAMA plate for a
patient with L4/5 spondylolisthesis. During the interval between the two
surgeries, we present our four topics to the spine team members. We have
short discussions after each presentation. At night, we have dinner with Dr
Gun, A/Prof Pongsathorn, the fellows and residents in the spine team at a
famous Thai food restaurant. We have a happy time with them.
Day 7 (Saturday - Sunday, November 8-9, 2014)
On the weekend we joint a local tour to the Dammnoen Saduak Floating
Market. The colourfully clad merchants at these lively markets paddle along
congested canals in sturdy canoes laden with fresh fruit and vegetables to sell
to shoppers on the banks. We have some local food there. After happy ending
in Bangkok, we moved to our last stop – Kuching, Malaysia on Sunday.
Kutching Day 1
(Mon, 10th November)
On our first day to the Sarawak General Hospital, we were greeted warmly by
Prof. Wong Chung Chek and the Orthopaedic departmental members. After
our brief introduction, we followed Prof. Wong to the ward to see his patients.
After that, we proceeded to join Prof. Wong in the operation theatre. He
performed a posterior decompression and fusion with supplement T8 PSO on
a patient with thoracic OPLL. Dr. Tzeng and Dr. Kim were given the privilege to
scrub in to join this surgery. Prof. Wong showed us how to insert thoracic
pedicle screws by using the “funnel technique”. After surgery, we have dinner
with the spine team members at a famous seafood restaurant.
Day 2
(Tue, 11th November)
The second day in Kuching was a free time. We joint a local tour to the Bako
National Park. We were attracted by the rainforest, abundant wildlife, jungle
streams, interesting plant life, secluded beaches, bizarre rock formations and
trekking trails. We visited Sarawak Culture Village in the afternoon. The village
residents provide information on their various traditional cultures and lifestyles.
We visited buildings that represent every major ethnic group in Sarawak;
longhouses of the Iban, Bidayuh and Orang Ulu, a Melanau tall-house and a
Chinese farm house among others. We also visited a theatre to enjoy
multicultural dance performances.